Bogart Laura M, Wagner Glenn J, Mutchler Matt G, Risley Brian, McDavitt Bryce W, McKay Tara, Klein David J
Division of General Pediatrics, Children's Hospital Boston, Boston, MA 02115, USA.
AIDS Educ Prev. 2012 Feb;24(1):1-14. doi: 10.1521/aeap.2012.24.1.1.
Treatment advocacy (TA) programs, based in AIDS service organizations and clinics, aim to engage clients into care and support antiretroviral treatment (ART) adherence through client-centered counseling; advocate for patients with providers; and provide social service referrals. Systematic evaluations of TA are lacking. We conducted a non-randomized evaluation examining relationships of TA participation to adherence, care engagement, social services utilization, unmet needs, patient self-advocacy, and adherence self-efficacy among 121 HIV-positive clients (36 in TA, 85 not in TA; 87% male, 34% African American, 31% White, 19% Latino). In multivariate models, TA participants (vs. non-TA participants) showed higher electronically monitored [85.3% vs. 70.7% of doses taken; b(SE) = 13.16(5.55), p < .05] and self-reported [91.1% vs. 75.0%; b(SE) = 11.60(5.65), p < .05] adherence; utilized more social service programs [Ms = 5.2 vs. 3.4; b(SE) = 1.97(0.48), p < .0001]; and had fewer unmet social-service needs [Ms = 1.8 vs. 2.7; b(SE) = -1.06(0.48), p < .05]. Findings suggest the need for a randomized controlled trial of TA.
以艾滋病服务组织和诊所为基础的治疗倡导（TA）项目，旨在通过以客户为中心的咨询，使客户接受护理并支持抗逆转录病毒治疗（ART）的依从性；为患者向医疗服务提供者进行倡导；并提供社会服务转介。目前缺乏对TA的系统评估。我们进行了一项非随机评估，研究了121名艾滋病毒呈阳性的客户（36名参与TA项目，85名未参与TA项目；87%为男性，34%为非裔美国人，31%为白人，19%为拉丁裔）中TA参与情况与依从性、护理参与度、社会服务利用情况、未满足的需求、患者自我倡导以及依从性自我效能之间的关系。在多变量模型中，TA参与者（与非TA参与者相比）在电子监测的依从性方面更高[服用剂量的比例分别为85.3%和70.7%；b（标准误）= 13.16（5.55），p <.05]，自我报告的依从性也更高[分别为91.1%和75.0%；b（标准误）= 11.60（5.65），p <.05]；利用了更多的社会服务项目[均值分别为5.2和3.4；b（标准误）= 1.97（0.48），p <.0001]；未满足的社会服务需求更少[均值分别为1.8和2.7；b（标准误）= -1.06（0.48），p <.05]。研究结果表明需要对TA进行随机对照试验。
